Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Indiana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Indiana only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Indiana (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Neel Shah (NPI 1356508915)

Field	Value
Entity Type	Individual
Organization	Neel Shah
Address	1001 Calumet Ave
City	Dyer
State	IN
ZIP	46311
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	May 21, 2008

Payer Source	Total Paid
Medicare	$3.2M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only biller: lifetime Medicare revenue is reported as $3.2M while there is no Medicaid billing on file, indicating payer mix is heavily concentrated in Medicare and the provider operates without measurable Medicaid activity. Analysts should treat this profile as single-payer (Medicare) for service-line and network planning.

Revenue concentration is high: the three top Medicare codes account for 75.9% of this provider's total Medicare revenue, signaling that a small set of high-cost injectable oncology therapies drives most dollars rather than a broad mix of low-cost E/M visits or lab work. This implies sensitivity to utilization or reimbursement changes for those few codes.

The practice is oncology-focused with a strong infusion/biologic therapy footprint: J9271 (pembrolizumab), J9119 (cemiplimab-rwlc), and J0897 (denosumab) are the top revenue contributors, consistent with immunotherapy and bone-targeted support common in hematology-oncology care. The presence of multiple high-volume chemotherapy and biologic drug codes plus chemotherapy administration code 96413 confirms infusion-based oncology services are central to operations.

Competitive standing on key biologics is pronounced for certain drugs: the provider ranks #69/1841 (96th percentile) nationally on J9271, indicating notably above-typical national volume for pembrolizumab infusions, and ranks #464/10057 (95th percentile) on J0897, also notably above typical national volume for denosumab. By contrast, J9119 shows modest absolute ranks (#3 of 5) and is described as typical/unremarkable volume; this mix indicates market strength on some agents but limited footprint on others.

Several evaluation-and-management (E/M) and chemotherapy administration codes show unusually high utilization relative to national peers: 99214 ranks in the 99th percentile and is labeled an "extreme outlier," while 96413 is in the 98th percentile and also an "extreme outlier." These positions suggest the provider delivers a large volume of moderate-complexity office visits and chemotherapy administration compared with the broader Medicare provider population, supporting a high-throughput outpatient oncology practice.

Operational throughput is supported by high-volume lab and phlebotomy activity: discrete lab CPTs (e.g., 36415, 85025 and multiple chemistry panels) all sit in very high percentiles (many in the high 90s), consistent with frequent on-site blood draws and routine monitoring tied to infusion cycles and immunotherapy follow-up. This aligns with an infusion-centric workflow that requires consistent lab monitoring.

The provider has long tenure in Medicare: NPI enumerated ~2008-05-21 (~18 years ago), indicating sustained participation in Medicare and potentially an established referral base and operational processes for oncology infusion care. This stability supports the high cumulative Medicare revenue and persistent utilization patterns seen across drug and E/M codes.

Payer and revenue risk concentration should be noted: with $3.2M in Medicare revenue and no Medicaid revenue, the provider is exposed to Medicare reimbursement policy shifts and utilization management for key biologics (notably J9271 and J0897). Payers or network managers evaluating this provider should consider negotiations or utilization oversight focused on those top codes since they represent the bulk of financial exposure.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

72 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	34,400	$40	$1.5M
J9119	Injection, cemiplimab-rwlc, 1 mg	25,900	$20	$543.9K
J0897	Injection, denosumab, 1 mg	16,020	$20	$288.4K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,600	$90	$142.4K
J1437	Injection, ferric derisomaltose, 10 mg	6,700	$20	$113.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	870	$90	$79.8K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	790	$60	$48.9K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	620	$80	$46.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	370	$130	$46.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	380	$90	$33.1K

Showing 1–10 of 72

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 72 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Indiana Distribution

Neel Shah — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. state median

72 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	2	20	11,200	$40	$631.7K
J9119	1	10	25,900	$20	$549K
J0897	7	220	2,730	$20	$74.9K
J1437	5	20	2,050	$20	$60.3K
Q5122	7	10	430	$100	$46.9K
J2506	2	10	370	$80	$33.1K
96413	4	120	140	$90	$19.1K
99214	38	10,540	110	$80	$15.5K
88185	7	10	530	$20	$13.5K
99233	249	2,720	80	$90	$13.4K

Showing 1–10 of 72

Related Providers

Other providers that share a Tax Identification Number (TIN) with Neel Shah, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Care Network Inc	IN	Family Medicine Physician	$0	$33.9M
St Catherine Hospital Inc	IN	General Acute Care Hospital	$0	$32.3M
Franciscan Health Crown Point	IN	General Acute Care Hospital	$0	$11.4M
Mohamad Kassar	IN	Hematology & Oncology Physician	$4.7M	$0
Ramon Lee	IL	Retina Specialist (Ophthalmology) Physician	$4M	$8.5K
Sohail Hasan	IL	Retina Specialist (Ophthalmology) Physician	$3.4M	$34.2K
Raja Devanathan	IN	Pulmonary Disease Physician	$3M	$0
Michael Tallarico	IN	Medical Oncology Physician	$2.7M	$0
Kourous Rezaei	IL	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Northwest Cancer Centers, PC	IN	Internal Medicine Physician	$0	$2.5M

Nearby Providers

Other providers in the same ZIP code as Neel Shah, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Health Dyer & Hammond	IN	General Acute Care Hospital	$0	$4.5M
Tae'ni Chang-stroman M.d., P.C.	IN	Pediatrics Physician	$0	$3.5M
Cannan Healthcare Services & Staffing Inc	IN	Home Health Agency	$0	$3.2M
Pathology Consultants Inc	IN	Anatomic Pathology & Clinical Pathology Physician	$0	$2.9M
Gowri Ramadas	IN	Hematology & Oncology Physician	$1.3M	$0
Shruti Singh	IN	Hematology & Oncology Physician	$1.1M	$0
Kunwarjit Duggal	IN	Physical Medicine & Rehabilitation Physician	$669.7K	$18.8K
Donna Ward	IN	Dermatology Physician	$579.4K	$0
Laura Hoffman	IN	Dermatology Physician	$493.4K	$0
Trevor Marcotte	IN	Family Medicine Physician	$477.8K	$0

Neel Shah — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References